Number of CCGs offering 3 IVF cycles has halved since 2013

The number of clinical commissioning groups (CCGs) in England offering the recommended 3 IVF cycles to eligible women under 40 has halved in the last 5 years: just 12 per cent now follow national guidance, down from 24 per cent in 2013. In contrast, the number of CCGs which have removed NHS IVF has almost doubled in the last year, according to latest figures released at the start of National Fertility Awareness Week by campaign group Fertility Fairness.

Fertility Fairness’ 2017 audit of England’s 208 CCGs reveals the severity of disinvestment in NHS fertility services, with potential further cuts ahead. While the number of CCGs following national guidelines and providing 3 NHS-funded IVF cycles has dropped to 12 per cent, the number of CCGs offering just one NHS-funded IVF cycle has leapt to 61 per cent (from 49 per cent in 2013), and there are now 7 CCGs that have removed NHS IVF (3.4 per cent). In 2015 the number of CCGs offering 0 cycles lay at 1 per cent, since then this figure has tripled. 7 per cent of CCGs are currently consulting on removing or reducing NHS fertility treatment.

Fertility Fairness’ data also reveals the best and worst places to live in England in terms of ability to access NHS IVF treatment, and for the first time provides the data in a league table of 17 ranked positions, so patients can see how their CCG compares to the rest of the country. The top 4 areas (ranked position 1) are all in Greater Manchester: Bury, Heywood, Middleton and Rochdale, Tameside and Glossop, and Oldham – the birth place of IVF 40 years ago. The worst areas (ranked position 17) do not offer any NHS IVF: Herts Valleys, Cambridgeshire and Peterborough, Croydon, South Norfolk, Basildon & Brentwood, Mid- Essex and North East Essex.

As well as cutting the number of IVF cycles offered, CCGs are finding alternative ways to reduce provision. National Institute for Heath and Clinical Excellence (NICE) guidelines recommend that eligible couples should have access to 3 full IVF cycles, where a full cycle of IVF treatment is defined as one round of ovarian stimulation followed by the transfer of all resultant fresh or frozen embryos. However, approaching half of all CCGs (49 per cent) use their own definition of what constitutes a full IVF cycle – and only transfer a finite number of embryos, rather than all resultant embryos.

Some CCGs stipulate entirely arbitrary age criteria for access to NHS IVF, in contravention of NICE’s guidelines stating that eligible women under 40 should be offered 3 full IVF cycles and eligible women aged 40-42 should be offered 1 full IVF cycle. Approaching half of all CCGs (48 per cent) do not offer NHS IVF to women aged 40-42; 10 per cent of CCGs refuse access to NHS IVF if women are over 35. And a few are currently consulting on proposals to only offer NHS fertility services to women aged between 30-35.

Sarah Norcross, co-chair of Fertility Fairness said: ‘The scale of disinvestment in NHS fertility services is at its worst since NICE introduced national fertility guidelines in 2004. Fertility Fairness is calling for full implementation of the NICE guidelines, standardisation of eligibility criteria across England and the development of a national tariff in England for tertiary fertility services – eliminating regional cost variants and removing a key barrier to CCGs’ compliance with national guidelines.’

Susan Seenan, co-chair of Fertility Fairness and chief executive of patient charity Fertility Network UK, said: ‘This National Fertility Awareness Week we are commemorating 40 years of IVF, 40 years of a life-changing technology pioneered in England. However, that achievement means nothing if only those who can afford private IVF benefit. The Government should be ashamed that, after 40 years of IVF, it is your postcode and your pay packet, and not your medical need, which are the key determinants of whether you will be able to try IVF.’

ENDS

Notes for editors

Contact: Catherine Hill media relations officer Fertility Fairness and Fertility Network UK on 07469-660845 media@fertilitynetworkuk.org Fertility Network UK media volunteers are available on request. Details of the audit are available at www.fertilityfairness.co.uk

1. NICE guidance recommends three cycles of IVF for women under 40 years and one cycle for some women aged 40-42. The latest data from Fertility Fairness shows that in England the majority of CCGs (88 per cent) do not offer three full cycles of NHS-funded IVF to eligible couples, as recommended by the National Institute for Health and Care Excellence 2004 guideline.

Year 0 Cycle Providers 1 Cycle Providers 2 Cycle Providers 3 Cycle Providers
2017 4% 61% 23% 12%
2016 2% 60% 22% 16%
2015 1% 57% 24% 18%
2014 1% 52% 29% 18%
2013 3% 49% 24% 24%

2. In Scotland, a new policy was introduced in April 17 enabling all health boards to fund 3 full IVF cycles for women under 40 and couples with children from previous relationships; in Wales, women under 40 are entitled to 2 full cycles, including couples with children from previous relationships and in Northern Ireland women under 40 are offered 1 partial cycle, including couples with children from previous relationships.

3. There is a move towards sustained disinvestment in NHS fertility services in England. The following CCGs do not provide NHS IVF: Mid-Essex, North East Essex, South Norfolk, Basildon and Brentwood, Croydon, Herts Valleys and Cambridgeshire and Peterborough The following CCGs are considering removing or cutting the number of NHS-funded IVF cycles they offer: West Essex, Southend, Bristol, North Somerset and South Gloucestershire, St Helens, all of Lancashire’s eight CCGs (Blackpool, Fylde &Wyre, Lancashire North, Chorley and South Ribble, Greater Preston, Blackburn with Darwen; East Lancashire, West Lancashire),

4. Fertility Fairness is a multidisciplinary umbrella organisation representing the major patient and professional bodies working in the field of fertility. Fertility Fairness campaigns for fair and equitable access to NHS-funded fertility services in accordance with national recommendations issued by NICE. This includes the right of eligible couples to receive up to 3 full cycles of IVF treatment regardless of where they live. The figures quoted above are from the fifth annual audit by Fertility Fairness of the provision of fertility services across England by CCGs using Freedom of Information requests. This is the most comprehensive data about fertility services to date. Details of the audit are available at www.fertilityfairness.co.uk

5. National Fertility Awareness Week 30 Oct- 5 Nov seeks to change perceptions, improve awareness, raise funds and provide support for everyone struggling with fertility issues. www.nfaw.org.uk